| NPI | 1558387506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AL 13003) |
| Additional Taxonomies | 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine (Licence: AL 13003) |
| 207XX0005X Orthopaedic Surgery Sports Medicine (Licence: AL 13003) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2023-03-07 |